Cafety

Question:

Hello,

I am a parent of a teen at a wildreness porgram (name removed) presently for usual reasons. My concern is after the program I feel she will benefit from a boarding school of some sort. She has underacheived in schools at home.   Are there any schools that you would recommend therapeutic or otherwise.

Thanks in advance for any help.

Sincerely

XXXX

P.S. Are they all bad?

Charley's Repsonse::

I will try to make general responses to your questions. Since I don't know your particular situation I realize that I am great risk of being irrelevant. As a psychiatrist in practice seeing many teenagers over more then 30 years, I can assure you I have seen it all.

First general principle: On average most kids will do better over time if they are at home. Time out of the home for treatment should be very limited as premature separation from parents is devastating for youth. You would never know it as they are yelling expletives at you all day and night and say they hate you. Bottom line kids need their parents in their lives and having to be separated adds another layer of damage if it goes on more then a month or two. Only love with disillusionment can create the kind of teen tantrum that kids can pull off. Leaving parents, i.e. emacipating, should be done with the youth having a sense of power in the process. When done right young people are more likely to be self sufficient and have great relationships with their parents - no matter how bad it may be in a mid adolescent moment.

Second general principle:

There are very few things that are likely to cause kids mortal injury in most communities. A few obvious things like guns with drunk kids at parties, or driving when intoxicate stand out. a very few youth get addicted to heroin, oxycotin or methamphetamine, and occasionally to highly refined cocaine products. By and large as big a mess as youth can make in using drugs and alcohol, few have lasting consequences. Life is a risk for the healthiest of teenagers, but being estranged from family and living apart for many months or years is in fact damaging.

Third major principle:

There are no proven effective treatments unique to residential programs. Some programs have elements of excellent programs usually done on an outpatient basis. There are questions if those treatments can be planted in residential care facilities. The best of facilities have to have rules that are inevitably tighter and more restrictive then in family homes. It is GOOD for a kid to be able to manipulate their daddy! It is good to occasionally indulge your daughter because she is just too cute. None of that kind of interaction can take place in a residential facility. And as a result it is hard for youth to feel special in a residential program. There are individual situations where a youth forges a family like relationship with a staff and real warmth is exchanged, but that is rare.

Fourth general principle:

There is a great deal of data on the effectiveness of some clinic based treatments. There is a lot of outpatient treatment that doesn't have any research evidence at all, but seems to be working well with many youth. It seems like a promising practice. An out patient counselor or therapist serving as an "outside the family" cool adult is in a viable set up for doing effective work if there is a good partnership between that therapist/counselor, the youth and the parents. They kid still has their community, their peers and all the risk factors that are necessary for growing up. When kids have multiple areas of their life where they have screwed up a team approach works well, i.e. the Wraparound Process. This approach mandates all the agencies and programs sit at the table with the parents empowered to take control of their kids care. That can happen when a community of parents can come together to support each other. This is the best context for effective treatment. Any treatment where the youth is not a respected and aren't active, willing participant is not likely to succeed.All this said, I understand that for many reasons, some good some bad, parents feel compelled to send their youth to a program or school for an extended period of time. No - they are not all bad, (as in evil-bad). Many in our group can cite examples of atrocity done to themselves or other youth. Those programs ARE EVIL. I have sat down with grieving parents of youth killed by gross abuse and neglect in facilities. Any parent should have their nose deep in any program their kids go to and have a bit of paranoia and willingness to see what may feel sketchy. The evil ones are not always easy for parents to discern. But well meaning folks do get into the teen help industry. Many programs with well meaning staff may be incompetent and ineffective. They ARE DUMB programs, not evil. They can be dangerous through inadvertent neglect or by letting a year or two go by with a kid "on ice" not getting educated and not growing emotionally. Then there are the good programs. They may have great ideals and competency but are trying to apply it in a setting that constrains growth even as staff strive to promote growth.

The question of good program is ARE THEY INEFFECTIVE???

I know there are good programs in terms of compassionate staff with adequate training, but are they effective? My own belief is that they aren't that effective very often.

Placing a teenager and not attending closely to what is happening to them, or of believing staff when they say to not listen to your kid as they are "only manipulating" is to take the risk of having your kid suffering horrific abuse. SO be very very careful and always have an index of suspicion for any program you choose.We take care to not recommend programs. We hear about the bad ones and have had confirmation from Congressional investigations that the problem of abuse is wide spread in the Teen Help industry. I would appreciate hearing from you and your daughter in a few years if you choose to put her in a program. I would love to hear ONE glowing report. I have seen not one at this point.

So be careful.